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Structural racism increases the risk of preterm birth and infant mortality in California

Black women in the US are at greater risk for preterm birth and infant mortality than white women. This is reflected in California, with 12% of Black women in 2016 having a preterm birth compared to 8% of White women. Many studies have put their focus on individual factors to try to explain this disparity, looking at things like behavioral risks or genetic and biological markers.

More recently, there has been a shift to looking at social determinants of health, including structural racism. Laws like redlining that systematically disadvantaged communities of color have lasting impacts on health. New research led by the Preterm Birth Initiative looks at how racial and economic disparities, and the ways they intersect, affect preterm birth and infant mortality among Black women in California.

The study explored outcomes for more than 47,000 Black women in California. They found that in zip codes with a higher concentrations of racially and/or economically disadvantaged groups, Black women had a higher odds of preterm birth and infant mortality. Women in the least privileged zip codes had a more than 25% higher chance of having a preterm birth compared with women who lived in the most privileged zip codes.

This aligns with previous research showing Black women in similarly disadvantaged neighborhoods in Boston had higher rates of preterm birth. By highlighting these differences among Black women, this body of research reinforces the idea that focusing on individual issues is the wrong priority. Researchers must explore how structural racism accounts for differences in birth outcomes.